漢方
Kampo/ja
漢方（かんぽう、kampo あるいは 漢方医学 ([kanpōigaku] Error: {{nihongo}}: text has italic markup (help))）は、単に漢方医学 ([中国医学] Error: {{nihongo}}: text has italic markup (help))として知られることもあり、7世紀に始まった伝来後、日本における伝統中国医学の研究である。日本の文化や伝統に合うように適応・修正された。日本の伝統医学では、鍼、灸、漢方伝統療法、漢方伝統食品療法など、中国の方法のほとんどを用いる。
| Kampo/ja | |||||
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| Japanese name | |||||
| Kanji | 漢方医学 | ||||
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| Chinese name | |||||||||||
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| Traditional Chinese | 日本漢方醫學 | ||||||||||
| Simplified Chinese | 日本汉方医学 | ||||||||||
| Literal meaning | "Han [Chinese] medicine in Japan" | ||||||||||
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歴史
起源
中国の神話によれば、伝統的な漢方薬の起源は伝説上の3人の君主伏羲、神農、黄帝にまで遡る。神農は何百種類もの薬草を試食し、その薬効と人体への影響を確かめ、人々の苦しみを和らげる手助けをしたと考えられている。植物の薬用のみに焦点を当てた最古の文献は、紀元前1世紀末頃に編纂された神農本草経で、365種の薬草を分類したと言われている。
608年、推古天皇は衛日（えにち）、福仁（ふくいん）ら若い医師を中国に派遣した。彼らはそこで15年間医学を学んだと言われている。838年まで、日本は19使節団を唐に派遣した。遣唐使が中国の統治機構を研究する一方で、医薬品や日本の僧侶の多くは中国の医学知識を吸収した。
日本の初期の適応
西暦702年、中国唐代の政治制度を応用した大宝律令が公布された。大宝律令は中国の唐の官制を取り入れたもので、その一節に医学部を含む大学（大學）の設立が謳われていた。光明皇后（701年-760年）は奈良の興福寺に悲伝院と施薬院を設立した。この2つの仏教施設は、貧しい人々に無料で医療と医薬品を提供していた。その後何世紀にもわたって、日本の仏教僧は中国の医学のノウハウを日本に伝え、エリート層と一般庶民の両方に医療を提供するために不可欠な存在であった。
西暦753年、医学に精通していた中国の僧侶鑑真は、12年間で5回の東シナ海横断に失敗した後、日本に到着した。彼は盲目であったため、嗅覚で薬草を見分けた。彼は医学書と膨大なマテリア・メディカのコレクションを奈良の御所に持ち込み、天平勝宝4年（756年）、聖武天皇の死後49日目に献上した。それらは正倉院として知られる東大寺（の丸太小屋風の宝物館に保管されている。
西暦787年、唐の朝廷から献上された『新訂本草綱目』（西暦659年）が厚生省の医学必修科目となったが、本草綱目に記載されている844種の薬物の多くは、当時日本では入手できなかった。西暦918年頃、中国の60の医学書から引用した「和名本草和名」が編纂された。
平安時代、丹波康頼（912-995）は日本初の医学書である医心方("医の心からの処方箋")を編纂した。多くの中国語のテキストを引用しているが、そのうちのいくつかは後に消滅してしまった。1200年から1600年にかけて、日本の医学はより実践的なものとなった。医師のほとんどは僧侶であり、遣唐使によって伝えられた処方、理論、実践を使い続けた。
Early revision
During the 15th and 16th centuries, Japanese physicians began to achieve a more independent view on Chinese medicine. After 12 years of studies in China Tashiro Sanki (1465–1537) became the leading figure of a movement called "Followers of Later Developments in Medicine" (Gosei-ha). This school propagated the teachings of Li Dongyuan and Zhu Tanxi that gradually superseded the older doctrines from the Song dynasty. Manase Dōsan, one of his disciples, adapted Tashiro's teachings to Japanese conditions. Based on his own observation and experience, he compiled a book on internal medicine in eight volumes (Keiteki-shū) and established an influential private medical school (Keiteki-in) in Kyōto. His son Gensaku wrote a book of case studies (Igaku tenshō-ki) and developed a considerable number of new herb formulas.
From the second half of the 17th century, a new movement, the "Followers of Classic Methods" (Kohō-ha), evolved, which emphasized the teachings and formulas of the Chinese classic "Treatise on Cold Damage Disorders" (Shanghan Lun, in Japanese Shōkan-ron). While the etiological concepts of this school were as speculative as those of the Gosei-ha, the therapeutic approaches were based on empirical observations and practical experience. This return to "classic methods" was initiated by Nagoya Gen'i (1628–1696), and advocated by influential proponents such as Gotō Gonzan (1659–1733), Yamawaki Tōyō (1705–1762), and Yoshimasu Tōdō (1702–1773). Yoshimasu is considered to be the most influential figure. He accepted any effective technique, regardless of its particular philosophical background. Yoshimasu's abdominal diagnostics are commonly credited with differentiating early modern traditional Japanese medicine from traditional Chinese medicine (TCM).
During the later part of the Edo period, many Japanese practitioners began to utilize elements of both schools. Some, such as Ogino Gengai (1737–1806), Ishizaka Sōtetsu (1770–1841), or Honma Sōken (1804–1872), even tried to incorporate Western concepts and therapies, which had made their way into the country through physicians at the Dutch trading-post Dejima (Nagasaki). Although Western medicine gained some ground in the field of surgery, there was not much competition between "Eastern" and "Western" schools until the 19th century, because even adherents of "Dutch-Studies" (Rangaku) were very eclectic in their actual practice.
Traditional medicine never lost its popularity throughout the Edo period, but it entered a period of rapid decline shortly after the Meiji Restoration. In 1871, the new government decided to modernize medical education based on the German medical system. Starting in 1875, new medical examinations focused on natural sciences and Western medical disciplines. In October 1883, a law retracted the licenses of any existing traditional practitioner. Despite losing legal standing, a small number of traditional physicians continued to practice privately. Some of them, such as Yamada Gyōkō (1808–1881), Asada Sōhaku (1813–1894), and Mori Risshi (1807–1885), organized an "Association to Preserve [Traditional] Knowledge" (Onchi-sha) and started to set up small hospitals. However, by 1887, the organization was disbanded due to internal policy dissent and the death of leading figures. The "Imperial Medical Association" (Teikoku Ikai), founded in 1894, was short-lived too. In 1895, the 8th National Assembly of the Diet vetoed a request to continue the practice of Kampō. When Azai Kokkan (1848–1903), one of the main activists, died, the Kampō movement was almost stamped out.
Era of Western influence
Any further attempt to save traditional practices had to take into account Western concepts and therapies. Therefore, it was graduates from medical faculties, trained in Western medicine, who began to set out to revive traditional practices. In 1910, Wada Keijūrō (1872–1916) published "The Iron Hammer of the Medical World" (Ikai no tettsui). Yumoto Kyūshin (1876–1942), a graduate from Kanazawa Medical School, was so impressed by this book that he became a student of Dr. Wada. His "Japanese-Chinese Medicine" (Kōkan igaku), published in 1927, was the first book on Kampō medicine in which Western medical findings were used to interpret classical Chinese texts. In 1927, Nakayama Tadanao (1895–1957) presented his "New Research on Kampō-Medicine" (Kampō-igaku no shin kenkyū). Another "convert" was Ōtsuka Keisetsu (1900–1980), who became one of the most famous Kampō practitioners of the 20th century.
This gradual revival was supported by the modernization of the dosage form of herbal medicine. During the 1920s, the Nagakura Pharmaceutical Company in Osaka began developing dried decoctions in a granular form. At about the same time, Tsumura Juntendō, a company founded by Tsumura Jūsha (1871–1941) in 1893, established a research institute to promote the development of standardized Kampō medicine. Gradually, these "Japanese-Chinese remedies" (wakan-yaku) became a standard method of Kampō medicine administration.
In 1937, new researchers such as Yakazu Dōmei (1905–2002) started to promote Kampō at the so-called "Takushoku University Kampo Seminar". More than 700 people attended these seminars that continued after the war. In 1938, following a proposal of Yakazu, the "Asia Medicine Association" was established. In 1941, Takeyama Shinichirō published his "Theories on the Restoration of Kampō Medicine" (Kampō-ijutsu fukkō no riron, 1941). In that same year, Yakazu, Ōtsuka, Kimura Nagahisa, and Shimizu Fujitarō (1886–1976) completed a book entitled "The Actual Practice of Kampō Medicine" (Kampō shinryō no jissai). By including Western medical disease names he greatly expanded the usage of Kampō formulas. A new version of this influential manual was printed in 1954. This book was also translated into Chinese. A completely revised version was published in 1969 under the title "Medical Dictionary of Kampō Practice" (Kampō Shinryō Iten).
In 1950, Ōtsuka Keisetsu, Yakazu Dōmei, Hosono Shirō (1899–1989), Okuda Kenzō (1884–1961), and other leaders of the pre- and postwar Kampō revival movement established the "Japan Society for Oriental Medicine" (Nippon Tōyō Igakkai) with 89 members (2014: more than 9000 members). In 1960, raw materials for crude drugs listed in the Japanese Pharmacopoeia (Nippon Yakkyoku-hō) received official drug prices under the National Health Insurance (NHI, Kokumin kenkō hoken).
Approved Kampō medicines
Today in Japan, Kampō is integrated into the Japanese national health care system. In 1967, the Ministry of Health, Labour and Welfare approved four Kampō medicines for reimbursement under the National Health Insurance (NHI) program. In 1976, 82 Kampō medicines were approved by the Ministry of Health, Labour and Welfare. This number has increased to 148 Kampō formulation extracts, 241 crude drugs, and 5 crude drug preparations.
Rather than modifying formulae as in traditional Chinese medicine, the Japanese Kampō tradition uses fixed combinations of herbs in standardized proportions according to the classical literature of Chinese medicine. Kampō medicines are produced by various manufacturers. However, each medicine is composed of exactly the same ingredients under the Ministry's standardization methodology. The medicines are therefore prepared under strict manufacturing conditions that rival pharmaceutical companies. In October 2000, a nationwide study reported that 72% of registered physicians prescribe Kampō medicines. New Kampō medicines are being evaluated using modern techniques to evaluate their mechanism of action.
Herbs
The 14th edition of the Japanese Pharmacopoeia (JP, Nihon yakkyokuhō) lists 165 herbal ingredients that are used in Kampō medicines. Lots of the Kampō products are routinely tested for heavy metals, purity, and microbial content to eliminate any contamination. Kampō medicines are tested for the levels of key chemical constituents as markers for quality control on every formula. This is carried out from the blending of the raw herbs to the end product according to the ministry's pharmaceutical standards.
Medicinal mushrooms like reishi and shiitake are herbal products with a long history of use. In Japan, the Agaricus blazei mushroom is a highly popular herb, which is used by close to 500,000 people. In Japan, Agaricus blazei is also the most popular herb used by cancer patients. The second most used herb is an isolate from the shiitake mushroom, known as active hexose correlated compound.
Outside Japan
In the United States, Kampō is practiced mostly by acupuncturists, Chinese medicine practitioners, naturopath physicians, and other alternative medicine professionals. Kampō herbal formulae are studied under clinical trials, such as the clinical study of Honso Sho-saiko-to (H09) for treatment of hepatitis C at the New York Memorial Sloan-Kettering Cancer Center, and liver cirrhosis caused by hepatitis C at the UCSD Liver Center. Both clinical trials are sponsored by Honso USA, Inc., a branch of Honso Pharmaceutical Co., Ltd., Nagoya, Japan.
こちらも参照
外部リンク
- International Society for Japanese Kampo Medicine (in English)
- Japan Society for Oriental Medicine (in English)
- "Current Kampo Medicine" (PDF). The Journal of Kampo, Acupuncture and Integrative Medicine (Special ed.). International Institute of Health and Human Services, Berkeley. November 2005. ISSN 1559-033X. Archived from the original (PDF) on 2016-03-03. Retrieved 2014-08-25.